Universal Health Precautions


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Universal Health Precautions

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Universal Health Precautions

  1. 1. Dr.T.V.Rao MD Dr.T.V.Rao MD 1
  2. 2. Who Is a Health care WorkerThe term health care worker refers to any person workingin health care settings and who has the potential forexposure to infectious materials including bodysubstances, contaminated medical supplies andequipment, contaminated environmental surfaces orcontaminated air . They include, but are not limited to,physicians, nurses, Laboratory technicians, therapists,pharmacists, nursing assistants, laboratory personnel,autopsy personnel, emergency medical service personnel,dental personnel, students and trainees Dr.T.V.Rao MD 2
  3. 3. What are Universal PrecautionsUniversal precautionare controlguidelines designedto protect workersfrom exposure toDiseases spread byBlood and otherBody fluids. CDC Dr.T.V.Rao MD 3
  4. 4. Why Universal Health Precautions. The concept of Universal Health Precautions emphasizes that all ourpatients should be treated as though theyhave potential blood born infections, andcan infect the caring health care workers. ( CDC ) Dr.T.V.Rao MD 4
  5. 5. MODES OF TRANSMISSION of Infections in Health CarePuncture wounds or cutsContact (touch, splash, orspray) with blood or OPIMon: mucous membrane non-intact skin cuts, abrasions, burns acne, rashes paper cuts, hangnails contaminated sharps
  6. 6. Human materials/Tissues considered Highly Infectious1 Blood most infectious2 Semen3 Vaginal secretions4CSF5 Synovial fluids6 Amniotic fluid7 All other body fluids Dr.T.V.Rao MD 6
  7. 7. Not Infectious unless contaminated with Blood or Body fluids.Feces,Nasal secretions,Sputum,Sweat,Tears,Urine / Vomitus,Saliva unless bloodstained. Dr.T.V.Rao MD 7
  8. 8. Universal Precaution StepsGloves (PersonalProtectiveEquipment)DecontaminationHand WashingWaste Disposal Dr.T.V.Rao MD 8
  9. 9. Use of GlovesUse of a pair ofdisposable plasticgloves can protect ifchances of contactwith Blood or Bodyfluid is anticipated/ inevitable. Dr.T.V.Rao MD 9
  10. 10. Step 1 Gloves...Always wear gloves when Direct contact with body fluids is anticipated (nosebleeds, bleeding abrasions, etc.) Handling clothes soiled by urine, feces, vomit or blood Dr.T.V.Rao MD 10
  11. 11. Step 2 …Gloves…One time use.If gloves not immediatelyavailable, use barrier such aspaper towels.When removing, peel offhands and roll glove outsidein.Discard gloves in linedwaste container.Wash hands after removinggloves. Dr.T.V.Rao MD 11
  12. 12. HAND WASHINGThere is no Healthprecaution like Handwashing.Washing with simpletoilet soap - reducesthe rate oftransmission ofcommon infectionsincluding the HIV. Dr.T.V.Rao MD 12
  13. 13. How to Wash our Hands Dr.T.V.Rao MD 13
  14. 14. Dr.T.V.Rao MD 14
  15. 15. Indications for Hand WashingIn prolonged contact with patient.Before taking care of Immune supressed,Newborn infants, patients in ICU / ICCU, DialysisUnits, Burn’s Units.Before and after touching wounds.When Microbial contamination of Hands, likelyto occur when in contact with mucousmembranes, body fluids, and other secretionscontaminated with Blood, and serous fluids. Dr.T.V.Rao MD 15
  16. 16. What to be used for hand washingIn most circumstances Non medicated soaps anddetergents are effective in removing mosttransient contaminants.In demanding circumstances, in handlingpotentially harmful infections, use Ethylor Isopropyl alcohol.Detergent formulations containing ChlorhexidinePovidone,or Hexachlorophene are effective inprevention of spread of infections. Dr.T.V.Rao MD 16
  17. 17. Use of Mask, Cap, Eye WearWill certainly protect usfrom splashes of Bloodor Body fluids.Dont underestimate theimportance of Use ofCap and Mask.Most important incollection of swabs inInfluenza Dr.T.V.Rao MD 17
  18. 18. Uses of Cap and MaskStringent use of Mask and Cap can save several Lives in the HospitalEg Swine flu Dr.T.V.Rao MD 18
  19. 19. Use of Foot wearWearing foot wearcovering entire soleprotects the entry ofMicrobes from thecontaminated floors withBlood and Body fluids.Remember many of ushave cracks on our feet. Dr.T.V.Rao MD 19
  20. 20. Use of Impervious GownA simple thin Plastic apron underneath the linen is of great help in preventing the soaking our inner clothes and exposure to harmful microbes. Dr.T.V.Rao MD 20
  21. 21. Disposal of Needles and Sharps All used needles and sharps should be deposited in thick walled puncture resistant containers. Bending, Reshaping, should be prohibited. Do not recap the needles to avoid needle stick injures, All used Disposable syringes and needles should be discarded into Bleach solution at the work station before final disposal. Dr.T.V.Rao MD 21
  22. 22. Dealing with Used NeedleShreddingcontinues to beImportantMethodOf dealing withused Needle Dr.T.V.Rao MD 22
  23. 23. You can Discard the Used Disposable Needles and Syringes in Bleached Solution Dr.T.V.Rao MD 23
  24. 24. SHARPS CONTAINERS MUST BE:closable and puncture resistantleak prooflabeled or color-coded color-functionalsufficient in numbereasily accessible andmaintained in upright positionreplaced per agency policyNOT be overfilled Dr.T.V.Rao MD 24
  25. 25. Accidental Exposure Alert your supervisor. Complete employee injury report. Follow-up with District’s Worker’s Comp medical provider for confidential evaluation. Dr.T.V.Rao MD 25
  26. 26. Hazards of Needle stick InjuriesHIV , HBV andHCV viral infectionscan spread byNeedle stick Injuries Nursing staff are atgreater riskSeveral Injuries arepreventable Dr.T.V.Rao MD 26
  27. 27. REPORTING AN INCIDENT Minimal Information to Report Date and time of incident Work practice being Job classification - followedTechnician Location in the worksite Procedure beingwhere incident occurred performed Dr.T.V.Rao MD 27
  28. 28. MEDICAL EVALUATION POST EXPOSUREEntitled to confidentialmedical evaluationPersonal decision aboutblood testingBlood may be testedonly with consentBlood may be stored for90 days, whileconsidering testingInterpretation of any testresults occurs with healthcare provider
  29. 29. BLOOD TESTINGBlood may be tested for antibodies to: Human Immunodeficiency Virus (HIV) Hepatitis C Virus (HCV) Hepatitis B Virus (HBV) disease- Other disease-causing organismsSource blood may also be tested withconsentResults of tests of source blood will bemade known to exposed person
  30. 30. Dealing with Needle stick InjuriesConsider all Needle stick injuries as a serioushealth hazard in the era of AIDSAll events of Needle stick injuries to be reportedto the supervisory staff.Wash the injured areas with soap and water.Encourage bleeding if any.Prophylaxis for prevention of HIV/HBV is toppriority.Anti retroviral prophylaxis, if necessary shouldstarted within 2 hours, ( if injury is from HIVpositive or high risk group). Dr.T.V.Rao MD 30
  31. 31. Do not Recap Needles It can cause Needle Stick Injury Dr.T.V.Rao MD 31
  32. 32. Decontamination of Hospital LinenAll the linencontaminated with Bloodor Body fluids should besoaked in 1: 100 bleachsolution for 30 minutes.Advised Autoclaving, asthe most ideal procedurefor decontaminatingLinen Dr.T.V.Rao MD 32
  33. 33. Spillage of Blood/Body fluids A common health hazard in the working environment. Never wipe the spillage with working wet mop.Always cover the spills with Blotting paper and pour 1 % Hypochlorite or Bleaching powder to decontaminate the spills with HIV/HBV virus. Dr.T.V.Rao MD 33
  34. 34. Decontamination of Metal InstrumentsHold all contaminated instruments with Glovedhands.Subject all metal instruments to washing withsoap and water.Treat all contaminated instruments with 2%Glutaraldehyde. For at least 30 minutes.Many consider sterilizing in Hot air oven if notsharp instruments. Dr.T.V.Rao MD 34
  35. 35. Pregnant Health Care WorkersNot at more risk than other,Health care workers.Should adopt UniversalHealth Precautions withmore dedication,If neglected the Unborn is atgrave risk of attainingcongenital infections.The Laboratory supervisorsshould monitor/ guide theHCW’s for adherence toscientific practices. Dr.T.V.Rao MD 35
  36. 36. Waste DisposalBag and tiePlace in second bag andtie again (double bagtechnique)Place all sharps (usedneedles) in sharpscontainer.Wash hands afterremovinggloves. Dr.T.V.Rao MD 36
  37. 37. Do Not Do Itbreak, shear, bend or recapneedlesreach into used sharpscontainerspick up contaminateditems, such as brokenglass with bare handsuse a vacuum cleaner toclean up contaminateditems Dr.T.V.Rao MD 37
  38. 38. Do Not Do Itpipette or mouth suctionblood or OPIMeat, drink, smoke, applycosmetics, or handlecontact lenses in areas ofpotential occupationalexposurestore beverages or foodin refrigerators, freezers,or cabinets where blood,other Samples arepreserved Dr.T.V.Rao MD 38
  39. 39. Operating on HIV/High risk groupsIt is a concern all shouldbe cared equally.Adherence of UniversalHealth precaution bringin safety to all HCW.Follow the precautionseven in Non HIVpatients as some of ourpatients are in windowperiod and moredangerous than trulypositive with Serotesting. Dr.T.V.Rao MD 39
  40. 40. HIV PREVENTION There is no vaccineto prevent HIVinfection Follow UniversalPrecautions
  41. 41. Importance of Vaccination in Hepatitis B Infection.We have > 400 Million carriers withHepatitis B infections.Every HCW is at risk of Contactinginfection.Vaccination is safe -GeneticallyEngineered vaccination remains the greathope for prevention, apart from Majorcomponent of Universal precautions. Dr.T.V.Rao MD 41
  42. 42. Vaccination for HBV infectionAll HCW’s must take atleast three doses of Vaccine,At 0 – 1 – 6 months. withoutdiscontinuation of theschedule.All Health care workersmany not attain equalresponse.High risk HCW’s shouldundergo estimation of antiHB s ( antibodies ) to knowwhether they were wellprotected. Dr.T.V.Rao MD 42
  43. 43. Problem of HBV vaccines in the Developing world Who pays for the Vaccine. Many who work in unorganized sector, do not get Institutional support of Vaccine. Life, at risk if Infected with HBV More Awareness to be brought in by Managers of the Hospitals, to promote to vaccinate their Employees. Dr.T.V.Rao MD 43
  44. 44. Never forget to take Hepatitis B Vaccine if You are a HCW Dr.T.V.Rao MD 44
  45. 45. Every one is a Important Member of the FamilyEvery health careworker is a Importantmember of the Family,one should take allpossible Health Careprecaution to save selfand other Members ofthe Family Dr.T.V.Rao MD 45
  46. 46. Created by Dr.T.V.Rao MD for ‘ e ‘Learning resources for Medical andParamedical Staff in the Developing World Email doctortvrao@gmail.com Dr.T.V.Rao MD 46
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